PURPOSE: Health interventions based on theory may be more effective than those that are not. This review of reviews synthesizes all published randomized controlled trial (RCT) meta‐analytic evidence from the last decade to examine whether theory‐based interventions were found to be associated with more effective adult health behaviour change interventions. METHODS: Systematic reviews including meta‐analyses were identified by searching Medline, CINAHL, PsycINFO, and CDSR. A narrative synthesis was used to summarize and analyse the evidence. Only reviews including RCTs of health behaviour change interventions with adults aged 18 + published from 2007 to 2017 were included. RESULTS: Of 8,659 articles, nine systematic reviews met inclusion criteria. The majority of reviews (<i>n</i> = 8) suggested no increased effectiveness for theory‐based compared to non‐theory‐based interventions for effectiveness of outcomes relating to health behaviour. Less than half of the RCTs included in the reviews reported the use of theory (85/183). Two reviews suggested interventions based on control theory, motivational interviewing, or self‐determination theory were associated with greater effectiveness for physical activity and/or dietary interventions and outcomes. Methodological and reporting issues limit the conclusions. CONCLUSIONS: Theory‐based interventions as currently operationalized in systematic reviews were not found to be more effective than non‐theory‐based interventions. Methodological and reporting issues at study and review level may not reflect the true utility of theory use within health behaviour interventions. The promotion of theory use may benefit from using a multifaceted argument, rather than a narrow focus of increased effectiveness. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
Numerous interventions for neuropathic pain (NeuP) are available, but its treatment remains unsatisfactory. We systematically summarized evidence from systematic reviews (SRs) of randomized controlled trials on interventions for NeuP. Five electronic databases were searched up to March 2015. Study quality was analyzed using A Measurement Tool to Assess Systematic Reviews. The most common interventions in 97 included SRs were pharmacologic (59%) and surgical (15%). The majority of analyzed SRs were of medium quality. More than 50% of conclusions from abstracts on efficacy and approximately 80% on safety were inconclusive. Effective interventions were described for painful diabetic neuropathy (pregabalin, gabapentin, certain tricyclic antidepressants [TCAs], opioids, antidepressants, and anticonvulsants), postherpetic neuralgia (gabapentin, pregabalin, certain TCAs, antidepressants and anticonvulsants, opioids, sodium valproate, topical capsaicin, and lidocaine), lumbar radicular pain (epidural corticosteroids, repetitive transcranial magnetic stimulation [rTMS], and discectomy), cervical radicular pain (rTMS), carpal tunnel syndrome (carpal tunnel release), cubital tunnel syndrome (simple decompression and ulnar nerve transposition), trigeminal neuralgia (carbamazepine, lamotrigine, and pimozide for refractory cases, rTMS), HIV-related neuropathy (topical capsaicin), and central NeuP (certain TCAs, pregabalin, cannabinoids, and rTMS). Evidence about interventions for NeuP is frequently inconclusive or completely lacking. New randomized controlled trials about interventions for NeuP are necessary; they should address safety and use clear diagnostic criteria.
This evidence map provides an overview of “mindfulness” intervention research and describes its volume and focus. It summarizes patient outcomes as reported in systematic reviews of randomized controlled trial evidence. We searched 10 electronic databases to February 2014, screened reviews of reviews, and consulted topic experts. We used a bubble plot as a visual overview of the distribution of evidence and synthesized results narratively in an executive summary. In total, 81 systematic reviews met inclusion criteria and the largest review included 109 mindfulness RCTs. Most research is available for general overviews on health benefits or psychological wellbeing. Reviews on chronic illness, depression, substance use, somatization, distress, and mental illness included 10 or more RCTs. Reviews suggest differential effects of mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and other mindfulness-based interventions, and definitions of “mindfulness-based” varied. The most consistent effect was reported for depression but published meta-analyses also indicated effects compared to passive control of MBSR on overall health, chronic illness, and psychological variables; MBCT for mental illness; and mindfulness interventions for somatization disorders. Limited evidence is also available for mindfulness interventions for pain, anxiety, and psychosis compared to passive control groups. More detail is provided for priority areas post-traumatic stress disorder, stress, depression, and wellness. The evidence map provides a broad overview (not detailed or definitive effectiveness evidence) over the existing research to help interpret the state of the evidence to inform policy and clinical decision making.
Health interventions based on theory may be more effective than those that are not. This review of reviews synthesizes all published randomized controlled trial (RCT) meta‐analytic evidence from the last decade to examine whether theory‐based interventions were found to be associated with more effective adult health behaviour change interventions.
METHODS:
Systematic reviews including meta‐analyses were identified by searching Medline, CINAHL, PsycINFO, and CDSR. A narrative synthesis was used to summarize and analyse the evidence. Only reviews including RCTs of health behaviour change interventions with adults aged 18 + published from 2007 to 2017 were included.
RESULTS:
Of 8,659 articles, nine systematic reviews met inclusion criteria. The majority of reviews (n = 8) suggested no increased effectiveness for theory‐based compared to non‐theory‐based interventions for effectiveness of outcomes relating to health behaviour. Less than half of the RCTs included in the reviews reported the use of theory (85/183). Two reviews suggested interventions based on control theory, motivational interviewing, or self‐determination theory were associated with greater effectiveness for physical activity and/or dietary interventions and outcomes. Methodological and reporting issues limit the conclusions.
CONCLUSIONS:
Theory‐based interventions as currently operationalized in systematic reviews were not found to be more effective than non‐theory‐based interventions. Methodological and reporting issues at study and review level may not reflect the true utility of theory use within health behaviour interventions. The promotion of theory use may benefit from using a multifaceted argument, rather than a narrow focus of increased effectiveness. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
